OTC Testing Flashcards
Factors Which May Increase LH Levels - Medications (3)
Menotropins
Clomiphene
GnRH agonist
Factors Which May Increase LH Levels - Other Causes (7)
Endometriosis Polycystic ovary syndrome Ovarian failure Hyperthyroidism (TSH) PTH and gonadotropin producing neoplasia Menopause Pregnancy
Factors Which May Decrease LH Levels
Danazol
• Estrogen/oral contraceptives
• Pituitary failure
• Certain hypothalmic defects
What causes High FSH Values - 3
Start of puberty
• Menopause
• Premature ovarian
failure
What causes Low FSH Values - 5
Prevents egg formation • Stress • Low body weight • Tumors of ovarian, hypothalamus, or pituitary gland • Polycystic ovary syndrome
Detection Window in Urine -Marijuana
/Cannabinoids
single use: 2 – 7 days
chronic use: 1 – 2 months
Detection Window in Urine -Cocaine
2 – 4 days
Detection Window in Urine -Morphine/Codeine
/Opiates
2 – 3 days
Detection Window in Urine -Phencyclidine (PCP)
14 days
chronic use: 30 days
Detection Window in Urine -Amphetamines
1 – 2 days
Urine Validity Testing - Markers: 4
Specific Gravity, Creatinine, Nitrites, pH
What Elevates Serum Creatinine - 9
Dehydration • Renal dysfunction • Urinary tract obstruction • Excess catabolism • Overexercising • Hyperthyroidism • Muscular dystrophy • Hyperpyrexia • Myasthenia gravis
What assays can be used to determine SCr levels? - 3
Jaffe Reaction, Enzymatic Essay, HPLC
- What clinical factors may justify 24-hour urine collection to calculate CrCl or GFR? - 6
Extremes of age and body size Severe malnutrition or obesity Disease of skeletal muscle Paraplegia or quadriplegia Vegetarian diet Pregnancy
What is BUN checked for? - 5
Presence or progression of kidney or liver
disease (renal function and catabolism in liver)
• Blockage of urine flow (renal function)
• Mental confusion (patients with kidney failure
are sometimes disoriented and confused)
• Abnormal loss of water from the body
dehydration (hydration)
• Recovery from severe burns
What could result in elevated BUN levels?
• Kidney disease or failure
• Blockage of the urinary tract by a kidney
stone or tumor
• Heart attack or congestive heart failure
• Low blood pressure
• Dehydration; fever; shock;
• Bleeding in the digestive tract
• Sometimes occurs during late pregnancy
• Eating large amounts of protein-rich foods
BUN:SCr > 20 Indicates
renal failure by
prerenal causes (each has to also be
outside normal limits)
– GI bleeding
BUN:SCr = 10-20
normal or postrenal
BUN:SCr < 10
suggests intrinsic kidney
damage
What factors can cause urine turbidity?
– Phosphates, urates (uric acid)
– RBCs, WBCs
– Proteins, bile acids
Which drugs can lead to urine color changes?
Red to Orange
Drugs that cause muscle damage, hemolysis,liver damage
As dye:
doxorubicin, daunorubicin, rifampin,
phenazopyridine, dantron, chlorpromazine,
chlorzoxazone
Which drugs can lead to urine color changes? Blue to green
As dye: amitriptyline, azuresin, methylene blue,
mitoxantrone, triamterene, resorcinol
Which drugs can lead to urine color changes? Brown to black
Drugs that cause muscle damage, hemolysis, liver damage
As dye: chloroquine, primaquine, metronidazole
and nitrofurantoin, sulfonamides
What are assessed during microscopic urinalysis? - 3
Assess three “Cs” – Cells, Casts, Crystals
– Microorganisms, RBC, WBC, tubular epithelial cells
(normal range: zero to trace)
– Cylindrical masses of glycoproteins formed in the
tubules
– Crystal presence in the urine depends on pH and
saturation of substances.
What are typically included in a dipstick urinalysis - 12
Protein Leukocyte Esterase pH Nitrite zero Specific Gravity Glucose Bilirubin Ketones Urobilinogen Electrolytes Blood and Hemoglobin %FENa 1-2%
Causes/Risks for CKD
• Diabetes
• Hypertension (CKD also causes hypertension)
• Glomerulonephritis
• Family history of kidney disease
• Kidney stones, tumors or an enlarged prostate
gland in men
• Repeated urinary infections
Drugs that Inhibit Tubular
Excretion of Creatinine - 8
- Cimetidine
- Triamterene
- Amiloride
- Spironolactone
- Trimethoprim
- Probenecid
- Aspirin
- Pyrimethamine
Quantitation Methods for
Urate -3
- Phosphotungstic acid methods
- Uricase methods
- HPLC methods
Gout: Major causes - 5
– Renal disease – Starvation or high protein weight reduction diets (metabolic overproduction) – Tissue damage – Radiation therapy – Cancer chemotherapy
What are the main features of nephrotic syndrome? - 4
- Striking proteinuria
- low albumin with increase of α2 globulin
- Increase in SCr, BUN, and uric acid
- Lipids in urine
Acute Renal Failure - Prerenal Causes - 3
• Prerenal: – Tubular injury which impairs the readsorption/secretion process – circulatory obstruction – kidney stone
Acute Renal Failure - Postrenal Causes - 3
• Postrenal
– bladder tumors
- enlarged prostate
- stones
Acute Renal Failure - Main Features - 3
- Decrease in urine output
- Increase in SCr and BUN
- Electrolyte and acid/base alterations
Primary Functions
of the Liver - 4
• Synthesis: – albumin, lipoproteins • Metabolism – Hemoglobin, hormones, amino acids • Detoxification – Drugs, environmental toxins, alcohol • Excretion
Liver Function Tests - 6
ü Total Serum protein (6.4-8.3 g/dL) ü Albumin (3.5 -5.5 g/dL) ü PT time • Bilirubin • Ammonia Ø Enzymes (ALP,AST,ALT, GGTP, LDH)
